By expanding Medicaid, Maine lawmakers can make a difference for the uninsured

Troy R. Bennett | BDN

Troy R. Bennett | BDN

In this January 2014 file photo, Sgt. Robert Elliot tries to organize hundreds of people headed through security screening at the State House in Augusta before a Maine People's Alliance rally urging legislators to make accepting federal Medicaid funds and expanding health care a top priority.

Tens of thousands of uninsured Mainers stand to gain access to affordable health coverage — many for the first time. They include hard-working people who do not receive health coverage through their jobs, who lost their jobs due to tough economic times or who have been diagnosed with a serious illness like cancer that prevents them from working full-time.

These individuals generally cannot afford adequate health insurance and are forced to put off needed care. They rely on emergency rooms or free or low-cost clinics for sporadic care. For someone managing a chronic disease such as cancer or cardiovascular disease, this type of patchwork medicine often results in poor health outcomes, and the resulting uncompensated care is a huge economic drain on Maine’s health system.

Gov. Paul LePage and state legislators have the opportunity to change this. At the same time, they could also reduce the burden that chronic diseases like cancer, heart and lung disease, and stroke have on our state. All they have to do is say yes to federal funding already set aside for Maine to increase access to the state’s Medicaid program, MaineCare.

If lawmakers make the right choice and vote to extend life-saving health coverage through Medicaid, nearly 70,000 people, who otherwise will not be able to afford health coverage, will have the security of knowing they have access to proven cancer, heart and lung disease screenings and treatments. Accepting the federal funds that have already been set aside for Maine would make health coverage available to individuals and families up to 138 percent of the federal poverty level ($20,921 for a family of two).

For those uninsured in Maine, this could be the difference between life and death. American Cancer Society research recently released found that uninsured adolescents and young adults are up to twice as likely as those with health insurance to develop late-stage cancer, which is more difficult and expensive to treat and more deadly than cancers caught early. This study builds upon earlier research released by the society that found a link between insurance status and cancer — people without health insurance are more likely to be diagnosed with later-stage cancers.

In addition, according to American Heart Association research, uninsured individuals with cardiovascular disease experience higher mortality rates and poorer blood pressure control than their insured counterparts, while those who suffer a stroke and are uninsured experience greater neurological impairments, longer hospital stays and up to a 56-percent higher risk of death than the insured.

The evidence is clear; increasing access to health coverage will save lives. By choosing to accept the federal funds set aside for Maine, our state’s hard-working, uninsured residents will be able to see doctors regularly, access preventive services such as mammograms, colonoscopies, asthma and blood pressure medication, and smoking cessation programs and avoid expensive and unnecessary visits to the emergency room.

Increasing access to health coverage through MaineCare will also save the state money. Cancer, heart and lung disease and other serious illnesses make up a large percentage of our state’s treatment expenditures. But by increasing access to Medicaid and helping some of the state’s most vulnerable citizens access preventive services and regular care, many of these illnesses can be detected and treated at earlier, less expensive stages — or even prevented altogether.

But it gets even better. Under the new health law, federal funds will pay 100 percent of the costs to provide health coverage to newly eligible individuals through 2016. After that, the federal contribution will gradually decrease. However, it will not fall below 90 percent. As Maine continues to face significant budget challenges, state leaders should be looking to this life-saving and cost-saving option.

We urge the governor and Legislature to accept the federal dollars already allocated for Maine, increase access to care for low-income Mainers and be a leader in improving the overall health of our state.

Dr. Alan Jansujwicz is a cardiologist in Bangor. Dr. Thomas Openshaw is a hematologist-oncologist in Brewer. Dr. Marguerite Pennoyer is an allergist/immunologist in Scarborough and a member of the Maine Leadership Board of the American Lung Association of the Northeast.